Ahmadu Bello University Zaria, Nigeria
Oladipo Aina has completed his M.Sc. and M.Res. at the Ahmadu Bello University, Zaria and University of Aberdeen, Scotland and presently working on his Ph.D. at the University of Aberdeen Scotland. He is presently a Lecturer in the Department of Community Medicine, Ahmadu Bello University Zaria where he teaches medical students medical sociology, behavioral science and health education. In addition to this he has supervised more than forty fi nal year medical students’ projects in Community Medicine. He has published about fi ve articles in local and international journals in addition to working as consultant to many local and international NGOs working in Nigeria in the area of public health.
In order to prevent deformities and interrupt transmission, one of the core strategies for leprosy control is early diagnosis and eff ective treatment. Th e operational classifi cation for treatment purposes is oft en not followed, because health workers are unsure about the actual bacterial load of the patients. Serology of leprosy can be used to classify patients for appropriate treatment and to identify contacts of leprosy patients at higher risk to develop leprosy. However, it was not clear whether the use of a rapid serological test in the fi eld would be feasible and acceptable. Would health workers without laboratory training be able to handle a serological test? Th is paper describes the multidisciplinary approach combining operational and anthropological study types used. We describe how we combined the two methods presenting the diff erent steps of the process: (1) planning the study; (2) development and evaluation of the rapid serological test; (3) project preparation; (4) training of health workers; (5) implementation of the fi eld studies; (6) data analysis. We also highlight the importance of combining the two study types. In a period of 18 months, a total of 2,632 patients and 5,226 contacts were included in the study by a team of 169 health workers. Th e time spent on the protocol preparation proved valuable but the majority of health workers indicated that the protocols were too extensive for routine use. Sixty four percent (49/76) of the health workers interviewed found that the test motivates contacts of leprosy patients to come to the health unit for examination. Control of test reading by the health workers showed 90% agreement between readers (kappa 0.8), and discordant results were borderline test results indicating that test reading did not pose a problem.